The invention relates generally to treatment for patients after open-heart and chest surgeries. More specifically, this invention relates to applying pressure to the whole of the patient""s chest area and to reduce dehesion of incisions post surgery.
Open heart and other chest surgeries have become pervasive in modern day medicine, accounting for numerous surgeries worldwide. Open-heart and other chest surgeries involve the cutting of the sternum bone along its medial line to separate the right rib cage from the left rib cage. This allows the heart and lung organs to be accessible to the surgeon and the equipment they use. After these types of surgeries are completed, the sternum bone has to be re-sewn together. For this, wires are used which help to hold the two sides of the cut sternum together. Holding the sternum together allows for the cut sternum once again to fuse together. Naturally, the cut sternum bones have to be aligned properly so that the process of fusing the bones can occur more rapidly and properly.
Although the cut sternum is sewn back together using wires, still movements in the chest area and chest muscles occur, which tend to cause dehesion or coming loose of the incision. Factors which contribute to movement of the chest area and ultimately dehesion of the incision are many. One of the side effects of open heart and other chest surgeries is that after surgery copious amounts of phlegm and other material such as blood will have to be expelled by coughing. In fact medical practitioners encourage patients to cough post surgery. Coughing causes a great deal of movement in the chest area causing movement in the incision area and movement where the cut sternum has been sewn together. Patients are also instructed not to use their hands and elbows to apply pressure to move when they are in bed. In order to get out of bed, patients must do so without using their hands. Additionally, patients are instructed not to perform any arm abduction movements. Movement in the chest area has to be suppressed as much as possible because of several reasons. First, movement of the pectoralis minor and pectoralis major muscles during arm movement, as well as movement caused by the contraction and expansion of the diagphram muscle, increases the chance for dehesion of the incisions. Movements in the incision area may cause dislocation of the sternum which increases the chance for infection of the chest area and the need for follow up surgeries. Second, improper fusion of the sternum or lack of fusion of the sternum would require re-cutting and/or re-attachment of the sternum. Finally, movement in the chest area is discouraged to reduce pain.
Other devices are currently being used to address some of the above-mentioned problems. The most popular of these devices is an ordinary pillow. A post surgery patient is given a pillow and instructed to apply pressure to the pillow during coughing. The drawback to this device is readily seen. First the patient must at all times hold the pillow over their chest. Coughing often occurs without notice and therefore, the patients must have the pillow available to them continuously. Additionally, when the patients are resting, their arms rest on their side. This position tends to stretch the pectoralis major and minor muscles and therefore acts to open the incisions in the sternum. Other devices used are seen in Lagin, U.S. Pat. No. 4,683,601, and Box et al. U.S. Pat. No. 5,154,691. Lagin discloses a medical pillow for use by patients who have undergone an open-heart surgery. The pillow eases the pain associated with coughing. Lagin also uses sleeves so that the patients"" arms can xe2x80x9cpullxe2x80x9d the pillow against their chest. This device allows for patients to rest their arms over their chest and in times of unexpected coughing allows them to quickly force the pillow towards their chest. However, this device actually forces the pectoralis muscles to stay in a stretched or extended position and while it may reduce the pain during coughing, still the patients will be contracting their pectoralis muscles to force the pillow towards their chest which operates to open the incisions. The ideal device will aid the patients to exert pressure on their chest and at the same time not contract their pectoralis muscles. Box, et al. U.S. Pat. No. 5,154,691 provides a xe2x80x9ccough pillowxe2x80x9d that is in close proximity to the surgical area. For this, Box provides straps that go around the shoulder and back of the patient. This device provides no sleeve and simply requires the patient to exert pressure on the chest by pulling the pillow towards the chest area.
In view of the foregoing, there is a significant need for a device and method to reduce movement of the chest area after open-heart or other chest surgeries.
Furthermore, there is a need for a device and method for applying pressure to the whole of the chest area during coughing to prevent dehesion of incisions.
Additionally, there is a need for a device that is readily accessible to the patients without the patients having to move their arms for placement of the device over the chest area.
The invention described is a pressure device for applying pressure to the whole of the chest area of a patient and for reducing the movement and dehesion of the sternum and chest incision after open heart and chest surgeries. The pressure device has a casing substantially in the form of a pillow or to receive a pillow. The casing has opposing lateral sides, a back side for application against the chest of the patient, the back side having top corners, a frontal side substantially on the opposite side of the back side of the casing, the frontal side having a top attachment portion and a bottom attachment portion. A membrane layer is attached to the top attachment portion and the bottom attachment portion of the frontal side of the casing, the outer wall of the frontal side and the inner wall of the membrane layer forming a sleeve for receiving the hands and forearms of a patient. A contiguous strap is attached to the top corners of the back side for attachment and support of the casing around the neck of the patient to provide for immediate proximity of the pressure device to the patient""s chest incision area. A gripping handle is also provided, for the patient to grab with his/her hands.
Optionally, the gripping handle has first and second handle portions, wherein the first and second handle portions are positioned on the opposing lateral sides of the casing.
The method of the invention discloses reducing the movement and dehesion of the sternum and chest incision of a patient after open heart and chest surgeries. The method has the following steps. The pressure device is placed on the chest area of the patient, the pressure device having a casing substantially in the form to receive a pillow as described herein, the casing having opposing lateral sides, each lateral side having a gripping handle. Supporting the casing around the neck of the patient provides for positioning the pressure device in the immediate proximity of the patient""s chest incision area. The patient then hugs the pressure device by extending the forearms through the sleeve formed by the membrane, thereby crossing the forearms over the pressure device, gripping the gripping handles on the opposing lateral sides, and then exerting pressure on the pressure device for reducing the movement and dehesion of the sternum.
Another method of the invention comprises expediting fusion of the cut sternum bone after open heart and chest surgeries. The steps for accomplishing fusion of the sternum bone comprises placing a pressure device on the chest area of the patient, the pressure device having a casing substantially in the form of, or to contain, a pillow, the casing having opposing lateral sides, each lateral side having a gripping handle. The method further includes supporting the casing around the neck of the patient for positioning the pressure device in the immediate proximity of the patient""s chest incision area. Additionally, the method includes hugging the pressure device by crossing the forearms over the pressure device and gripping the gripping handles on the opposing lateral sides, thereby exerting pressure on the pressure device for reducing the movement and dehesion of the sternum. Alternatively, the method of the invention includes inserting the hands and the forearms into a sleeve positioned on the front surface of the casing.